类风湿关节炎患者B细胞上Fas受体表达与疾病活动度相关性研究

目的 测定类风湿关节炎（RA）患者B淋巴细胞表面Fas及可溶性Fas/FasL（sFas/sFasL）的表达，研究B淋巴细胞Fas受体在RA发病中的作用。方法 流式细胞术检测CD20⁺标记的B淋巴细胞及Fas的表达，酶联免疫吸附试验检测sFas/sFasL的水平。结果 RA组血清及关节液sFas/sFasL水平均高于对照组（P<0.01），RA组外周血Fas表达率高于对照组（P<0.01），CD20⁺B淋巴细胞表面受体Fas表达率低于对照组（P<0.01）。结论 RA中sFas、sFasL表达升高，可能通过抑制致病淋巴细胞凋亡，促进RA发病；RA发病中T/B淋巴细胞比例紊乱，外周血淋巴细胞Fas升高而B淋巴细胞Fas表达降低，可能是由sFas/sFasL升高引起。

Correlation Between Expression of Fas Receptor Molecules on B Lymphocyte and Disease Activity of Rheumatoid Arthritis

Objective To investigate the role of B lymphocyte and Fas receptor mediated apoptosis in the pathogenesis of rheumatoid arthritis(RA) through detecting the count of peripheral B lymphocytes, apoptosis factor of Fas expression and the level of soluble Fas/FasL (sFas/sFasL) in serum and synovial fluid apoptosis index. Methods The percentage of CD20⁺ in B lymphocytes and apoptosis factor of Fas in peripheral blood were detected with flow cytometry(FCM) their correlation with clinical index was and analyzed. Serum and synvial fluid levels of sFas/sFasL were determined by enzyme-linked immunosorbent assay (ELISA) and their correlation with clinical index was amalyzed. Results The level of sFas/sFasL in the serum and synvial fluid in RA patients were higher than that in normal controls (P<0.01).The prevalence of Fas cell in peripheral blood of RA patients was significantly higher than normal controls (P<0.01). The prevalence of CD20⁺ in B lymphocytes and Fas receptors of B lymphocyte surface in peripheral blood of RA patients was significantly lower than normal controls (P<0.01). Conclusion Increasing expression of sFas and sFasL in RA may be promote RA disease by inhibiting pathogenic lymphatic cell apoptosis. B lymphocytes were reduced in RA lead to T/B lymphocytes dysfunction and breaking the mechanisms of immune system. Fas rose in peripheral blood lymphocyte and the B lymphocytes of Fas is reduced, which may be caused by the hoist of sFas/sFasL.